The Sinister Side of Weight-Loss Drugs
Ever heard the expression “too good to be true?” We’re warned about the over-zealous claims of any product from a young age. But somehow the warning signals around Ozempic and its other glucagon-like peptide-1 receptor agonist brethren (GLP-1 RA or just GLP-1s) continues to be drowned out by the hype.
It doesn’t matter that we’ve been here before with amphetamines for weight-loss in the 1940s and 50s, or Prozac for depression in the 90s, or statins for heart disease, or any number of other “it” drugs being captured by the media. The vast marketing departments of Big Pharma are winning the battle against common-sense and real – you know – data!
GLP-1 drugs focus on a symptom – the poor glucose control of diabetes or simply weighing more than desired or “optimal” – without addressing the root cause of either symptom, or considering the severe adverse health effects on the body of the drug itself.
From profound physiological changes, altered brain chemistry and psychological distress, to kidney damage and cancer, the threat to the long-term health of users is so often ignored or down played in the frenzy.
What Are GLP-1 RA’s?
Ozempic was developed by Novo Nordisk, a Danish pharmaceutical company, and received FDA approval for Type 2 diabetes in 2017. On discovering that the drug also led to weight-loss the company launched a higher dose variety Wegovy marketed for obesity which received approval in 2021. Its active drug is semaglutide, which can also be found in Rybelsus.
In parallel, Eli Lilly developed Mounjaro, approved in 2022 for Type 2 diabetes and Zepbound, for weight-loss in 2023, using the active drug tirzepatide.
Saxenda and Victoza are two other varieties based on the drug liraglutide.
Most of these drugs are delivered via injection due to their poor absorption via the oral route. Of course there is a scramble to develop more oral options with additional (unnatural) ingredients to increase absorption into the bloodstream.
All have similar actions in the body in that they act on the complex glucose feedback mechanism that regulates blood sugar. Glucagon is a hormone produced in the pancreas like insulin but is an antagonist to insulin: whereas insulin decreases circulating glucose, glucagon increases it. Research into these processes led to the discovery of glucagon-like peptides which are produced in the intestines and are also powerful hormones that cue satiety – makes us feel full so we eat less – amongst other actions.
All the mechanisms involved are not entirely understood by scientists wherein lies the problem: appetite-control and weight-loss may be the obvious effects, but there are a myriad of other effects happening at the same time throughout the body that are not so desirable.
Adverse Effects on Health of GLP-1 RA’s
Already one in eight adults has tried these drugs but they are too new to assess the long-term health implications. A quick glance at the FDA’s ongoing adjustments to the warning labels gives you some sense of the common and potentially serious effects of trying to manipulate a single aspect of the perfectly designed human body.
Here’s just a few of the negative effects most clearly identified to date:
GLP-1s affect the nervous system which helps with appetite reduction but also slows down the passage of food through your stomach. Delayed gastric emptying can lead to gastroparesis: stomach paralysis, a serious condition. Nausea and vomiting are common symptoms in the early stages. Other gastrointestinal damage includes bowel obstruction and permanent structural changes to the intestines causing poor nutrient absorption. In one study, compared to bupropion-naltrexone (another obesity medication) GLP’s were found to have:
- 9 times the risk of pancreatitis
- 4 times the risk of bowel obstruction
- 4 times the risk of gastroparesis
While GLPs are touted for their extreme weight-loss effects, up to a third of the weight-loss is often lean muscle mass leading to sarcopenia (literally “poverty of flesh” in Greek) which can lead to frailty. Muscle is metabolically active affecting many aspects of our health and vitality. One study found that people over aged 40 with sarcopenia were almost twice as likely to be hospitalized as those without the condition. Severe osteoporosis has been seen in young adults after a year on the drug, a particular concern for the misguided attempt to convince us children need these drugs.
GLP-1 receptors are not only in your intestines, but in your brain as well including the areas responsible for emotions and reward systems, influencing dopamine levels. So at the same time as curbing your appetite they are dulling your desires for other activities like social engagements, activity and even sexual intimacy. One study noted “patients on GLP-1 RAs exhibited a 195% higher risk of major depression, a 108% increased risk for anxiety, and a 106% elevated risk for suicidal behavior”. Another study based on a WHO database confirmed the increased risk for suicidal tendencies.
Reports are starting to emerge of kidney damage occurring weeks after starting the medications. A type of scarring that leads to kidney failure is strongly indicated but also related conditions like high blood pressure, electrolyte imbalances, and severe protein loss in the urine.
Many users report dry mouth which sounds innocent enough but the drugs seem to cause a reduction in saliva production and a corresponding increase in the bacteria P. gingivalis. Bad breath also sounds benign but is a sign of periodontal disease. Poor dental health interferes with your innate immune response and raises your risk of Type 2 diabetes, heart disease, pneumonia, autoimmune disease, and mental health issues. The term “Ozempic Teeth” is starting to pop up on social media.
Any form of cancer is a complex multi-faceted disease that is often the outcome of years of poor health. But safety signals are starting to sound about GLP-1s contributing to the risk. Thyroid cancer is already a risk for those who are obese but a recent study has caused the European Medicines Agency to issue a drug safety signal for GLP-1s. Your thyroid is your master hormone regulator so over-stimulating it with an unnatural amount of hormone-mimicking compounds is not without consequences. Similarly, overstimulation of the pancreas can lead to pancreatitis (mentioned under #1) and ultimately cancer.
In clinical trials, 80-90% of users suffered at least one adverse effect. These are not rare occurrences. Understanding a little about the intricate codependences of all systems in the human body can give you the smallest inkling that mimicking a hormone to influence one mechanism or pathway, will always have knock-on consequences.
Your individual risk of a particular adverse effect rises the longer you are on the drug. One of the most problematic aspects of these drugs is that any benefits incurred are reversed as soon as the drug is stopped; the rebound weight is severe. The loss of muscle and bone density certainly contributes to the weight returning but also the fact that the root cause of the diabetes or weight-gain has not been addressed in the “magic-pill” attitude.
Getting to the Root Cause of Weight Gain
Normalizing a prescription to address metabolic health is a huge step in the wrong direction. Here’s just a few culprits that should be addressed first:
Poor gut health, microbiome disruption
Unbalanced hormones
Thyroid disfunction
Liver impairment
Sedentary lifestyle
Lack of protein and good fats in meals
Processed food including seed oils and high fructose corn syrup
Chemicals in our food like pesticides, food colorings and additives
Nutrient deficiencies
Poor sleep quality
The list is endless and highly personal. Read How to Be a Healthy Human for a better understanding of the intricacies of the human body and what you can do about it.
What About Diabetes?
These drugs were originally developed to help diabetics improve their A1C levels and they can certainly do that, but at what cost? Your score on a blood test is not a full picture of your overall health.
If your A1C is lower but your kidney function has declined and you’re feeling kind of depressed, is that an improvement in health? The marketing of statins has a similar emphasis on the reduction in LDL cholesterol numbers without mentioning the side-effects of statin use. Interestingly a recent study has shown that statins aggravate insulin resistance through reducing GLP-1 levels.
GLP-1 RA’s and statins are two of the biggest block-buster pharmaceuticals on the market but neither is making anyone any healthier. They are certainly generating huge profits for shareholders though.
A Better Approach for Weight-Loss or Diabetes
As with all health issues, you need to look at the root causes and address them in a way that works for you. But here’s a few ideas to get you started:
There is no short-cut to good health and longevity. The little choices you make every day will have the biggest impact. Start small and address one habit at a time gradually addressing all key areas: your food, activity level, sleep, water-intake, stress management, toxic load from various sources and relationships (not necessarily in that order).
By far the biggest impact on your health is what you put into your body as food followed by how you eat. Choose whole organic foods (mostly plants) and don’t eat after the sun goes down. Intermittent Fasting or Time-Restricted Eating are fancy terms for just eating as God intended. Have dinner around 6 or 7pm and then don’t eat again until “break-fast” at least 12 hours later, maybe longer. It takes a few hours for your body to finish digesting the last meal and switch into repair and detox mode. An extended fast will also help your body become more metabolically flexible and keep blood sugar stable.
Lean muscle mass will help you maintain your blood sugar and burn more calories at rest. It doesn’t require hours in a gym but whatever puts a little strain on your muscles will benefit more than just your waistline. Walking uphill or up and down stairs, swimming, cycling, dancing, gardening, carrying heavy groceries, squatting while brushing your teeth . . . get creative.
A popular ingredient in salad dressings and the main component of drinks dubbed “natural Mounjaro” on the internet, apple cider vinegar has been shown to increase metabolic rate and promote fat burning. It contains a host of beneficial compounds which helps your microbiome and enhances immunity. A research review also highlighted its anti-inflammatory effects and impact on lipid profiles and glycemic parameters. Pour 5-10mls on your salad or add to a glass of water daily.
For example, berberine at 500mg three times a day has been shown to be as effective as the drug Metformin at improving A1C levels (with none of the side effects). Other useful supplements are chromium, zinc, magnesium, vitamin C, vitamin D and coenzyme Q10. Herbal remedies includes cinnamon, garlic and ginger. Curcumin (the active ingredient in turmeric) has been shown to be effective at preventing prediabetics developing full blown diabetes.
The more you understand your own personal root causes the more empowered you will be to address them. No magic pill is ever going to be the answer and in most cases will be detrimental to your overall health and flourishing.
For Employers
Employers have an important role to play in changing the conversation around GLP-1s and how we address health more broadly. Given that 80 million people in the US are covered by their employer’s health insurance, whether or not these drugs are subsidized or not impacts their use.
It’s a delicate balance to be sure. Most employers would say they do not want to interfere in doctor/patient discussions and prefer to simply support employees in managing their health conditions as they see fit. Though this attitude was sorely lacking in 2021/22 with employers suddenly mandating a pharmaceutical intervention but I digress . . .
The cost/benefit analysis of GLP-1 medications is very thin. Some employers have tried to limit coverage by requiring lifestyle modification at the same time, requiring lower cost medications to be tried first, limiting coverage to employees with only a diabetes diagnosis, or limiting the duration of coverage. Increasingly employees seek out lower cost options via Direct-to-Consumer arrangements and compounding pharmacies. The conversation needs to change.
For the price of a GLP-1 RA prescription you could provide each employee with a personal coach or access to a functional medicine professional to help them get to the root cause of their diabetes or weight problems and affect their health for the better. There are a myriad of wonderful health solutions available, many focusing on the root cause of metabolic disfunction using AI to personalize interventions for the individual.
If you really want to help employees improve their health, invest less in the conventional health plan and more in interventions that work!
